The experts have learned more about small cell lung cancer, methods of its prevention, best treatment method, and best care approach for the diagnosis of small cell cancer patients. The oncogenesis of small cell lung cancer has been the primary public concern, resulting in an increased mortality rate. Different treatment approaches have brought advancement in the treatment of small-cell lung cancer. Cytotoxic chemotherapy is considered the backbone of the treatment. Still, as small cell lung cancer is chemo-sensitive, clinical research has shown that high response rates among small cell lung cancer patients are not usually translated into the cure. Hence, it is high time progress is made in the small cell lung cancer research as every success in the clinical trial is a battle fought, and every failure is a lesson learnt. The latest study of small cell lung cancer has improved the prognosis of the patients. Some of the significant research areas have provided new options for the patients through the conduction of several clinical trials. Some of them are mentioned below:
- Personalized therapy: Researchers have been looking forward to the different characterization of the lung tumors that helps predict whether the particular treatment for small cell lung cancer shows efficacy or not. The small cell lung cancer patients have been asked for additional analysis of the tumor samples taken during the disease diagnosis. The amount of tissue removed during the initial biopsy phase may not be efficient for carrying out other clinical approaches. In this case, the patients are asked to undergo another biopsy for helping the experts in carrying out future studies for planning effective treatment as clinical trials for helping the researchers find better ways to treat small-cell lung cancer.
- Targeted therapy is the treatment approach in small cell lung cancer that aims to target the specific gene, protein, and tissue for cancer development, growth, and survival. It is effective as it tends to block the growth and spread of tumor cells while limiting damage to the healthy cells. The targeted therapy Rovalpituzumab is under progress in the research study for small cell lung cancer. Rovalpituzumab is the drug used in small cell lung cancer, combined with antibody attaching to the protein DDL3, identified on the cells of small cell lung cancer patients.
- Immunotherapy: The PD-1 pathway is considered a critical approach to control tumor growth by blocking the path with PD-1 and PD-L1 antibodies. The PD-1 and PD-L1 antibodies have stopped or slowed the growth of lung tumors in some of the small cell lung cancer patients. Ongoing research on immunotherapies and new approaches to using this treatment has been considered the latest research on small cell lung cancer.
- Radiation therapy: The expertise are finding more methods for improving the efficacy of radiation therapy while minimizing the impact of side effects on small cell lung cancer patients. Several studies are researching stereotactic radiation therapy that focuses on radiation directly on the cancer cells and avoids the healthy tissues.
- Improved screening: The treatment of small cell lung cancer can be easily carried out during its diagnosis at early stages. It has increased the interest in screening more individuals for small cell lung cancer before analyzing signs and symptoms.
- Eliminating the use of tobacco: Although different screening and treatment methods have shown a success rate in minimizing the risk of small cell lung cancer, still the best way for preventing small cell lung cancer is through the adoption of interventional programs that motivate individuals to quit smoking and never begin with smoking habits. The stopping of smoking habits among small cell lung cancer individuals have increased their shelf-life, reduced any side-effects and minimized the chance of getting second-time small cell lung cancer. The healthcare team is conducting several research studies to help individuals quit smoking habits with nicotine replacement and other techniques. Other research studies are being undertaken to allow individuals to get rid of smoking habits.
- Palliative care/supportive care: Several clinical trials are being conducted to find better ways to reduce the symptoms and side effects of current small cell lung cancer treatment. It tends to improve the quality of life of small cell lung cancer patients.
Approximately 10–25% of small cell lung cancer patients are diagnosed with brain metastasis during the initial diagnosis phase. More chance with 40-50% is predicted to develop during other disease courses 1. The first-line treatment in metastatic small cell lung cancer consists of a combination of platinum and etoposide 2. But this resulted in poor survival of the patients as most of the patients experienced relapse within the first year of treatment. Other agents or the addition of other drugs did not show any improvement in the patient’s outcome. Hence, there is a need for therapies that improve patient survival with small cell lung cancer. Recent developments have been made in staging, surgery, radiotherapy, and systemic treatment involving immunotherapy since the landmark reviews published in the last decade 3. Single-agent regimens of standard cytotoxic agents, including paclitaxel, docetaxel, gemcitabine, and vinorelbine, are being studied in phase II clinical trials as second-line therapies with moderate results. Hence, several clinical evaluations of new treatment strategies for small cell lung cancer while focusing on the agents responsible for changing the prognosis of the disease.
- 1.Slotman B, Faivre-Finn C, Kramer G, et al. Prophylactic Cranial Irradiation in Extensive Small-Cell Lung Cancer. N Engl J Med. Published online August 16, 2007:664-672. doi:10.1056/nejmoa071780
- 2.Mascaux C, Paesmans M, Berghmans T, et al. A systematic review of the role of etoposide and cisplatin in the chemotherapy of small cell lung cancer with methodology assessment and meta-analysis. Lung Cancer. Published online October 2000:23-36. doi:10.1016/s0169-5002(00)00127-6
- 3.Demedts IK, Vermaelen KY, van Meerbeeck JP. Treatment of extensive-stage small cell lung carcinoma: current status and future prospects. European Respiratory Journal. Published online December 31, 2009:202-215. doi:10.1183/09031936.00105009